Incidence of diabetes mellitus at postpartum six to twelve months following the diagnosis of gestational diabetes mellitus

Abstract

Objective:The aim of this study was to research the rates of diabetes mellitus (DM) and the risk factors that may play a role in the prediction of this condition by evaluating patients with the diagnosis of gestational diabetes mellitus (GDM) at the 6 th -12 th postpartum months. Material and Method:Among 109 cases who had been invited to the hospital for oral glucose tolerance test (OGTT) at the 6 th -12 th postpartum months, 84 cases (77%) were enrolled in the study. To the 78 patients that were found to be appropriate according to the study criteria, 75 gr OGTT was administered. Patients who had new pregnancies during the period of postpartum screening, and those with previously diagnosed DM were excluded from the study. Results:While the results of 23 cases (29.5%) included in the study were normal, 27 cases (34.6%) were diagnosed with DM and 28 cases (35.9%) were diagnosed as having an impaired glucose tolerance and /or impaired fasting glucose (IGT/IFG). Among patients diagnosed with DM, the history of DM in the first degree relatives (n=21, 77.8%, p=0.018), body mass index before pregnancy (mean=30.1±4.4, p=0.009) and insulin requirement for the treatment of GDM (n=25, 92.6%, p<0.05) were determined at higher rates. In the logistic regression analysis, multiparity (OR=2) and insulin requirement during pregnancy (OR: 7.27) were found to be the predictive factors in the development of postpartum DM. Discussion:In this study, the determination of high rates of DM development in the postpartum period after GDM demonstrates the necessity of augmentation in efforts to increase the screening rates after delivery and to increase the patients' acknowledgement of this topic. (J Turkish-German Gynecol Assoc 2010; 11: 89-94) Key words: Gestational diabetes mellitus, postpartum, OGTT Received: 20 February, 2010 Accepted: 11 April, 2010 Amaç: Bu çalışmada gestasyonel diyabetes mellitus (GDM) tanısı alan hastaların postpartum 6-12.aylar arasında değerlendirilmesi sonucunda diyabetes mellitus (DM) saptanma oranları ve bu durumun öngörülmesine katkısı olabilecek risk faktörlerini araştırmak amaç-lanmıştır. Gereç ve Yöntemler:Postpartum 6-12. aylar arasında oral glikoz tolerans testi (OGTT) için hastaneye davet edilen 109 hastadan 84 (%77) olgu çalışmaya başvurdu, çalışma kriterlerine uygun 78 hastaya 75 gr OGTT uygulandı. Postpartum tarama zamanında tekrar gebelik tespit edilen veya daha önce DM tanısı alan hastalar çalışma dışı bırakıldı. Bulgular:Çalışma kapsamındaki hastalardan 23 (%29.5) olgunun sonuçları normalken; 27 olguya (%34.6) DM, 28 (%35.9) olguya bozulmuş glikoz toleransı ve/veya bozulmuş açlık glikozu tanısı konuldu. DM tanısı alan hasta grubunda 1.derece akrabalarda DM öyküsü (n=21, %77.8, p=0.018), gebelik öncesi vücut kitle indeksi (ortalama=30.1±4.4, p=0.009) ve GDM tedavisi için insülin gereksinimi (n=25, %92.6, p<0.05) daha fazla oranda tespit edildi. Yapılan lojistik regresyon analizi sonucunda multiparite (OR=2) ve gebelikte insülin tedavisi gereksiniminin (OR: 7.27) postpartum DM gelişimi iç...

Incidence and Contributing Factors of Persistent Hyperglycemia at 6–12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study

“…Another report by Langer showed that fasting glucose > 105 mg/dL was associated with fetal macrosomia, hypoglycemia in newborn infants, cesarean delivery, and a need for insulin therapy [48]. Previous studies have failed to determine an association between fasting glucose and future progression to type 2 diabetes for several reasons as follows: it was not measured [49]; the variable was not entered in the statistical model [50]; or modeling excluded GDM women with high fasting glucose level [39, 51] in the studies [7, 52]. …”

“…Some previous studies have shown an association of maternal age, parity, and a family history of diabetes with glucose intolerance, but reports are inconsistent [7, 39, 52]. …”

Preferences of participating in diabetes screening programs for postpartum women with gestational diabetes mellitus in a university hospital in Turkey

“…In our study, one-fifth of the women who participated in the screening in the postpartum phase was diagnosed with type 2 diabetes by the physician. In a similar study, 78 women had an OGTT between the 6th and 12th months postpartum, and according to the screening results, 34.6% of women were found to have type 2 diabetes and 35.9% were found to have impaired glucose tolerance or impaired fasting glucose [4]. In other studies, the prevalence of type 2 diabetes was reported between 4.5% and 30%, according to the results of postpartum screening among women who were diagnosed with GDM during pregnancy [7,15,[18][19][20][21].…”

“…There is a risk of developing type 2 diabetes from GDM during and after the postpartum period. In the literature, it has been reported that approximately one-third of women diagnosed with GDM develop type 2 diabetes in the postpartum period [4], and more than half University hospital in Turkey of them who are diagnosed with GDM develop type 2 diabetes in five years [3]. Women with a history of GDM may prevent or delay the risk of developing type 2 diabetes through healthy lifestyle changes, such as a healthy diet, reaching an ideal weight and maintaining it, engaging in regular physical activity and quitting smoking in the postpartum period [5].…”